When I Got Told I Couldn’t Present Freebirth as an Empowered Choice
How the narrative shifts when women make choices that don't always align with the medical model of birth.
Birth work is full of contradictions.
We talk about bodily autonomy, informed choice, and the right to birth how you wish - until, apparently, that choice is freebirth. Then suddenly, the narrative shifts.
Once, I celebrated a family’s choice
Many moons ago, I created a reel celebrating a client’s choice to freebirth. It wasn’t a reckless decision. It wasn’t made out of fear. It was something that had been discussed and considered from day 1.
She was a neurodiverse woman who deeply understood her own physiology. She knew from the start of her pregnancy that, if she wasn’t able to get the support she needed, she would rather stay home.
The data supports this - not just for neurodiverse women but for most women. Home birth has excellent safety outcomes, and for sensory-sensitive individuals, the hospital environment can be completely counterproductive to physiological birth.
As it turned out, when we reached out for support during labour, the hospital refused to send a team. Even though there were people working on the wards, they said staffing levels meant they needed these staff in the hospital. So, she made a choice. A fully informed, fully powerful choice to stay put in the place where she felt safest.
She knew baby was coming soon. She felt confident in her body. She trusted her knowledge and instincts. And she birthed her baby beautifully at home.
I shared this as a story of trust, power, and autonomy - because that’s exactly what it was.
And then, a midwife commented:
"I would absolutely advise against advocating or celebrating ‘freebirth’ at home without a fully trained medical professional present."
The conversation continued in my DMs, where I was told that I shouldn’t be presenting it as an empowered choice.
Right. Because women are only capable of making empowered choices when those choices align with a system that we know often already disempowers them? It’s far more nuanced than hospital = good + safe and home/freebirth = bad + dangerous.
Firstly - what IS safety?
Let’s talk about safety within the medical model. To truly know what is safe, we’d need fully accurate and reliable measures that considerably reduce poor outcomes. Yet, various reports - from the MBRRACE-UK reports to the Birth Trauma Inquiry - show that it isn't as simple as "intervene more, save more lives."
In fact, the latest MBRRACE-UK data reveals that the maternal death rate in the UK has increased significantly over the past few years. Between January 2020 and December 2022, the rate was 13.41 per 100,000 maternities, up 53% from 8.79 per 100,000 in the previous three-year period from 2017-2019. This rate is the highest it has been in almost 20 years.
Additionally, the Birth Trauma Association highlights that about 4-5% of women develop post-traumatic stress disorder (PTSD) after giving birth - equivalent to approximately 25,000-30,000 women every year in the UK.
Mental health-related issues continue to be the leading cause of deaths occurring between six weeks and one year after pregnancy. Postnatal care is completely depleted, meaning many moving through these traumatic experiences receive very little support.
These statistics paint a concerning picture. They suggest that increased interventions do not necessarily lead to better outcomes. Instead, they may contribute to a bubbling lack of trust in women's bodies, perpetuate the perspective that "the doctor knows best", and uphold a medical model designed to manage birth rather than support its natural process.
Informed choice is important
Making informed, empowered choices does not look one way. The beauty of our rights and rules in the UK means we should be respecting an individual's autonomy to make choices that are right for them - even if it's not something we'd choose for ourselves.
This is one of the pillars of doula care - to not convince, cajole, or encourage either way. To carve out the space and time, to support with information, and to fully respect the autonomy of the women we work with.
If we're going to champion true bodily autonomy, then that includes the autonomy to birth wherever - and with whomever - feels safest for that person. Of course, freebirth isn’t the right choice for everyone. But that’s the point - birth autonomy isn’t about telling people what they should do. It’s about supporting people in making the choices that are right for them - with full information, trust, and respect.
So tell me - have you ever felt like certain birth choices were allowed to be seen as empowered, while others were always framed as reckless? Let’s talk.
